Cone Beam CT With Flat Panel Detector and Biplane Fluoroscopy-Guided Percutaneous Trigeminal Nerve Rhizotomy Using Three-Dimensional Needle Trajectory Planning.

Trigeminal-mediated pain disorders can be devastating for patients refractory to medical therapy. Gasserian ganglion blocks and percutaneous trigeminal rhizotomy have been used with success to treat these patients, however, serious complication risks include facial hematoma, cranial nerve palsy, and stroke. Cone beam CT, combined with fluoroscopy and needle navigation has been shown to decrease needle pass rates, procedure time, radiation exposure, and complications in multiple interventional radiology procedures, but hitherto has not been utilized for Gasserian ganglion interventions.

Certified Examination Assistants in the Age of Telemedicine: A Blueprint Through Neurology.

The optimal approach to a clinical physical examination via telemedicine is still being explored. The medical community has no standardized or widely followed criteria for telemedicine examinations, so a broad spectrum of approaches is used. Unfortunately, the need for telemedicine is outpacing physical examination validation research.

Ischemic Stroke Induced Area Postrema Syndrome With Intractable Nausea, Vomiting, and Hiccups.

The area postrema (AP) is a small, circumventricular organ located in the dorsal medulla and is characterized by an anastomosed capillary network with no blood-brain barrier. It contains the chemoreceptor trigger zone for vomiting, which is activated by noxious stimuli in the blood. Lesions to the AP produce a clinical syndrome referred to as area postrema syndrome (APS), which is characterized by intractable nausea, vomiting, and hiccups.

Spinal Cord Stimulator Explant and Revision Complicated by Syrinx Formation: A Case Report and Literature Review.

Spinal cord stimulation (SCS) has been shown to be a safe, effective, and drug-free treatment option for many chronic pain conditions including refractory low back pain. The most commonly reported complication of SCS is equipment failure. We report a case of spinal cord injury (SCI) during SCS explant and revision.

Further Evidence that Onabotulinum Toxin is a Viable Treatment Option for Pediatric Chronic Migraine Patients.

Introduction Chronic migraine is particularly devastating. It affects school work, extracurricular activities, and quality of life, including relationships with other family members, and can also influence the mental health of both the migraineurs and family members. According to the International Classification of Headache Disorders, 3rd edition (ICHD-3), chronic migraine is defined as 15 or more headache days per month for greater than three months, where at least on eight days per month, there are features of migraine headache.

Iatrogenic Spinal Epidural Hematoma Associated with Intracranial Hypotension.

Epidural steroid injections (ESIs) are one of the few modalities currently in use for treating chronic spinal pain. There are two approaches: interlaminar ESIs and transforaminal ESIs. Complications arising from either approach are rare, but one such complication is cerebrospinal fluid (CSF) leak leading to intracranial hypotension.

A Case Report of Recombinant Tissue Plasminogen Activator Use in a SPAN-100-Positive Geriatric Patient with Thrombocytopenia.

Thrombocytopenia (platelet count: < 100,000/mm) is considered a contraindication in the use of intravenous thrombolysis for acute ischemic stroke. Little literature exists regarding tissue plasminogen activator (tPA) usage in thrombocytopenic patients, especially in older patients. Age and stroke severity are major prognostic indicators of the risk of hemorrhagic transformation.

Integrated treatment approach improves cognitive function in demented and clinically depressed patients.

The purpose of this study was to evaluate the efficacy of an integrative treatment approach on cognitive performance. The study sample comprised 35 medically ill patients (20 male, 15 female) with an average age of 71.05, who were diagnosed with mild dementia and depression.